Efficacy and Safety of Emricasan in Liver Cirrhosis and/or Fibrosis
This study aimed to perform a meta-analysis to determine the efficacy and safety of emricasan. Nine databases were searched for clinical trials investigating the efficacy of emricasan treatment in patients with liver cirrhosis or fibrosis. A manual search was conducted to identify the missing trials...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2021-06-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100412&tlng=en |
| _version_ | 1811228021748662272 |
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| author | Li-ya Mu Shu-qin Li Li-xin Tang Rui Li |
| author_facet | Li-ya Mu Shu-qin Li Li-xin Tang Rui Li |
| author_sort | Li-ya Mu |
| collection | DOAJ |
| description | This study aimed to perform a meta-analysis to determine the efficacy and safety of emricasan. Nine databases were searched for clinical trials investigating the efficacy of emricasan treatment in patients with liver cirrhosis or fibrosis. A manual search was conducted to identify the missing trials. The quality of the included studies was assessed using the revised Cochrane risk of bias tool. Efficacy of emricasan treatment was defined as a positive change in apoptosis-related parameters from baseline to the last follow-up visit. Overall, emricasan treatment is more effective in patients with liver cirrhosis or fibrosis than placebo (standardized mean difference [SMD] [95% confidence intervals (CI)]=0.28 [0.14; 0.41]). No significant change in model for end-stage liver disease (MELD) score between the emricasan and placebo groups was noted (SMD [95% CI]=0.18 [-0.01; 0.36]; p=0.058). A 50 mg dose of emricasan had the highest efficacy rate compared to placebo (SMD [95% CI]=0.28 [0.06; 0.50]; p=0.012), followed by the 5 mg dosing regimen (SMD [95% CI]=0.28 [0.06; 0.50]; p=0.012). Treatment with emricasan resulted in significant reductions in ALT (mean difference (MD) [95% CI]=-5.89 [-10.59; -1.20]; p=0.014) and caspase3/7 levels (MD [95%CI]=-1215.93 [-1238.53; -1193.33]; p<0.001), respectively. No significant increase in the rate of overall adverse events was noted (OR [95% CI]=1.52 [0.97; 2.37]; p=0.069). Treatment with emricasan is more effective in improving liver function and apoptosis parameters compared to placebo, with a well-tolerated safety profile. However, due to the poor quality of the analyzed studies, the small number of trials and patients, and the short follow-up periods, more robust trials are still warranted. |
| first_indexed | 2024-04-12T09:51:30Z |
| format | Article |
| id | doaj.art-e4cabc548c644293a5555d0b44d2bed3 |
| institution | Directory Open Access Journal |
| issn | 1980-5322 |
| language | English |
| last_indexed | 2024-04-12T09:51:30Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-e4cabc548c644293a5555d0b44d2bed32022-12-22T03:37:49ZengElsevier EspañaClinics1980-53222021-06-017610.6061/clinics/2021/e2409Efficacy and Safety of Emricasan in Liver Cirrhosis and/or FibrosisLi-ya Muhttps://orcid.org/0000-0002-8772-7020Shu-qin Lihttps://orcid.org/0000-0002-7922-903XLi-xin Tanghttps://orcid.org/0000-0002-5072-6411Rui Lihttps://orcid.org/0000-0002-9234-8594This study aimed to perform a meta-analysis to determine the efficacy and safety of emricasan. Nine databases were searched for clinical trials investigating the efficacy of emricasan treatment in patients with liver cirrhosis or fibrosis. A manual search was conducted to identify the missing trials. The quality of the included studies was assessed using the revised Cochrane risk of bias tool. Efficacy of emricasan treatment was defined as a positive change in apoptosis-related parameters from baseline to the last follow-up visit. Overall, emricasan treatment is more effective in patients with liver cirrhosis or fibrosis than placebo (standardized mean difference [SMD] [95% confidence intervals (CI)]=0.28 [0.14; 0.41]). No significant change in model for end-stage liver disease (MELD) score between the emricasan and placebo groups was noted (SMD [95% CI]=0.18 [-0.01; 0.36]; p=0.058). A 50 mg dose of emricasan had the highest efficacy rate compared to placebo (SMD [95% CI]=0.28 [0.06; 0.50]; p=0.012), followed by the 5 mg dosing regimen (SMD [95% CI]=0.28 [0.06; 0.50]; p=0.012). Treatment with emricasan resulted in significant reductions in ALT (mean difference (MD) [95% CI]=-5.89 [-10.59; -1.20]; p=0.014) and caspase3/7 levels (MD [95%CI]=-1215.93 [-1238.53; -1193.33]; p<0.001), respectively. No significant increase in the rate of overall adverse events was noted (OR [95% CI]=1.52 [0.97; 2.37]; p=0.069). Treatment with emricasan is more effective in improving liver function and apoptosis parameters compared to placebo, with a well-tolerated safety profile. However, due to the poor quality of the analyzed studies, the small number of trials and patients, and the short follow-up periods, more robust trials are still warranted.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100412&tlng=enEmricasanLiver CirrhosisLiver FibrosisCaspaseHepatic Function |
| spellingShingle | Li-ya Mu Shu-qin Li Li-xin Tang Rui Li Efficacy and Safety of Emricasan in Liver Cirrhosis and/or Fibrosis Clinics Emricasan Liver Cirrhosis Liver Fibrosis Caspase Hepatic Function |
| title | Efficacy and Safety of Emricasan in Liver Cirrhosis and/or Fibrosis |
| title_full | Efficacy and Safety of Emricasan in Liver Cirrhosis and/or Fibrosis |
| title_fullStr | Efficacy and Safety of Emricasan in Liver Cirrhosis and/or Fibrosis |
| title_full_unstemmed | Efficacy and Safety of Emricasan in Liver Cirrhosis and/or Fibrosis |
| title_short | Efficacy and Safety of Emricasan in Liver Cirrhosis and/or Fibrosis |
| title_sort | efficacy and safety of emricasan in liver cirrhosis and or fibrosis |
| topic | Emricasan Liver Cirrhosis Liver Fibrosis Caspase Hepatic Function |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100412&tlng=en |
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